Arthritis Care & Research最新文献

{"title":"Alternative to opioids in resolving spondyloarthropathy-related back pain: comment on the article by Degirmenci et al.","authors":"Bruce Rothschild","doi":"10.1002/acr.80076","DOIUrl":"10.1002/acr.80076","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, histological, and serological predictors of renal function loss in lupus nephritis.","authors":"Shangzhu Zhang, Laurence Magder, Daniel Goldman, Judith A James, Joel M Guthridge, Carla Guthridge, Peter Izmirly, Jill P Buyon, H Michael Belmont, Richard A Furie, Noa Schwartz, Chaim Putterman, Jennifer L Barnas, Jennifer H Anolik, Sarah French, Maria Dall'era, Avi Z Rosenberg, Jeffrey Hodgin, Dawit S Demeke, Michelle Petri, Andrea Fava","doi":"10.1002/acr.80070","DOIUrl":"https://doi.org/10.1002/acr.80070","url":null,"abstract":"<p><strong>Objective: </strong>Kidney survival is the ultimate goal in lupus nephritis (LN) management, but long-term predictors remain inadequately studied, requiring long-term follow-up. This study aimed to identify baseline and early longitudinal predictors of kidney survival in the Accelerating Medicines Partnership LN longitudinal cohort.</p><p><strong>Methods: </strong>We performed time-to-event analyses of clinical, centrally scored histological, and serological predictors of kidney function loss (sustained ≥ 40% eGFR decline or progression to end-stage kidney disease) in 172 LN patients with a median follow-up of 4.6 years (range 0.5-7.8).</p><p><strong>Results: </strong>Kidney function loss occurred in 57/172 (33%) patients. Baseline lower eGFR, non-first kidney biopsy, and higher NIH Chronicity Index (CI) were associated with eGFR loss. CI was the strongest predictor, but no clear threshold defined higher risk. NIH Activity Index and International Society of Nephrology (ISN) class were not predictive. Proteinuria at 12 months was prognostic, with urine protein to creatinine ratio <0.7 g/g associated with lower risk, though no single threshold ensured protection, and lower levels had better outcomes. Lack of complete clinical response at 3, 6, or 12 months predicted future eGFR loss, while partial response conferred intermediate risk. Serological markers were not associated with eGFR loss.</p><p><strong>Conclusion: </strong>Low baseline eGFR and chronic histologic damage, but not activity or ISN class, predicted eGFR loss. Proteinuria <0.7 g/g at 1 year was associated with better outcomes but did not ensure protection. Since proteinuria does not reflect intrarenal inflammation, these results suggest current response definitions serve better as prognostic indicators than true measures of treatment efficacy, and better biomarkers are needed.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world trends in prenatal antirheumatic drug utilization in Ontario, Canada: A cross-sectional time-series analysis.","authors":"Shenthuraan Tharmarajah, Swaleh Hussain, Sara J T Guilcher, Lisa M McCarthy, Dharini Mahendira, Howard Berger, Mina Tadrous","doi":"10.1002/acr.80079","DOIUrl":"10.1002/acr.80079","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to describe real-world trends in preconception and prenatal use of antirheumatic drugs among pregnant individuals with rheumatic diseases in Ontario, Canada.</p><p><strong>Methods: </strong>We conducted a time-series analysis using repeated cross-sectional data to examine annual patterns of disease-modifying antirheumatic drug (DMARD) use among pregnant individuals with rheumatoid arthritis, systemic lupus erythematosus, psoriatic arthritis, and/or axial spondyloarthritis. The study included those with Ontario Drug Benefit Program (ODB) coverage who delivered between April 1, 2006, and March 31, 2021. For calendar years 2007, 2011, 2015, and 2019, we described demographic, clinical, and DMARD use characteristics among ODB beneficiaries.</p><p><strong>Results: </strong>The cohort included 5,256 pregnant individuals, with 576 preconception and 697 prenatal ODB beneficiaries. Preconception DMARD use remained relatively stable, but biological DMARD use increased by 293.1%, from 8.3 to 32.8 users per 100 eligible population from fiscal years 2006 to 2020 (p = .004). Prenatal DMARD use rose by 5.7% (p = .02), with biological DMARD use increasing by 775.0%, from 3.6 to 31.3 users per 100 eligible population (p < .001). Across the annual cohorts, the proportion of prenatal DMARD users nearly doubled from 26.3% to 45.2% (p = .01). Among users, the proportion receiving a single DMARD rose to 32.9% in 2019, while the proportion receiving 2 or more DMARDs also rose to 12.3% (p = .02).</p><p><strong>Conclusion: </strong>Prenatal antirheumatic drug use has increased, particularly for biological DMARDs. These trends reflect evolving treatment practices aimed at optimizing disease control and pregnancy outcomes for individuals with rheumatic diseases.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance between systemic lupus erythematosus disease activity index domain weights and their association with organ damage accrual.","authors":"Kevin Zhang, Eric F Morand, Sarah E Boyd, François Petitjean, Alberta Hoi, Rachel Koelmeyer, Iolanda Miceli, Julie A Monk, Hieu T Nim","doi":"10.1002/acr.80077","DOIUrl":"https://doi.org/10.1002/acr.80077","url":null,"abstract":"<p><strong>Objective: </strong>Studies of damage accrual in patients with systemic lupus erythematosus (SLE) show associations with disease activity measured by the SLE Disease Activity Index 2000 (SLEDAI-2K), but these associations are imperfect. SLEDAI scores are powerfully influenced by weightings (1-8) assigned to each domain. We investigated whether the weightings of SLEDAI-2K domain scores aligned with the risk of organ damage accrual.</p><p><strong>Methods: </strong>In patients with SLE attending a single center from 2007-2016, disease activity (SLEDAI-2K) and organ damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index; SDI) were recorded prospectively at each visit and annually, respectively. Visits were dichotomized according to whether the visit occurred during a period of damage transition (increase in SDI in the same year). Associations were assessed using Fisher's exact test (univariable analysis) and generalized linear mixed-effect models (multivariable analysis).</p><p><strong>Results: </strong>We analyzed 5,538 visits of 266 patients (86.5% female, 51.5% White). SLEDAI-2K domains positively associated with damage transition all had weights of <4 (odds ratio [95% CI]: pericarditis 5.39 [1.59-18.3] P < 0.01; pleurisy 2.12 [1.14-3.94] P = 0.02; arthritis 1.40 [1.02-1.94] P = 0.04; leukopenia 1.52 [1.04-2.24] P = 0.03). Higher-weighted SLEDAI-2K domains were negatively associated with damage transition, not associated, or were too infrequent to assess.</p><p><strong>Conclusion: </strong>Associations of SLEDAI-2K domains with damage accrual were variable and were discordant with domain weightings. Alternative weighting strategies for disease activity instruments could improve their prognostic utility.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic Granulomatous Mastitis Presenting as Refractory Inflammatory Breast Disease in a Young Woman.","authors":"Tarun Selvarajan, Shravya Balmuri, Liubou Kazacheuskaya, Sarwat Umer, Samina Hayat","doi":"10.1002/acr.80075","DOIUrl":"https://doi.org/10.1002/acr.80075","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty: A New Vital Sign in Rheumatology Care?","authors":"Alexandra Legge, Katherine D Wysham","doi":"10.1002/acr.80072","DOIUrl":"10.1002/acr.80072","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Impacts and Predictors of Cannabis Products used by Rheumatology Patients in Alberta: A Multivariable Analysis of Cross-sectional Survey Data.","authors":"Susan Zhang, Samuel A J Lowe, Frank Sun, Allyson Jones, Tarek Turk, Joanne Olson, Pauline Paul, Shelby Yamamoto, Linda Kolewaski, Elaine Yacyshyn, Cheryl A Sadowski","doi":"10.1002/acr.80071","DOIUrl":"https://doi.org/10.1002/acr.80071","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to characterize cannabis product choices (cannabinoid content and formulation) among rheumatology patients, and their associations with patient factors, patient reported perceived side effects and positive impacts.</p><p><strong>Methods: </strong>An online survey (delivered from March to November 2022) was distributed by Alberta Health Services to rheumatology patients in Alberta. Correlation matrices were used to analyzed associations between cannabinoid content and formulations reportedly used with patient factors and patient-reported outcomes. Efficacy outcomes (e.g. pain, sleep, mood) were grouped into a composite positive impact score and side effects were grouped into CNS activating, dampening, and sensory effects.</p><p><strong>Results: </strong>Data from 1,436 respondents who indicated cannabis use and provided information on their rheumatologic condition, cannabinoid content and formulations that they use were analyzed. THC-CBD balanced products were associated with higher positive impact scores, aOR(95%CI)=1.76(1.18-2.63). THC-dominant products were also associated with high dampening and sensory effects, aOR=1.85(1.16-2.98) and 2.16(1.27-3.70), respectively. Dried cannabis and edibles were associated with higher positive impact scores aOR=1.86(1.07-3.23), and 2.18(1.41-3.37), respectively. Dried cannabis was also associated with high dampening and sensory effects, aOR=1.98(1.19-3.27) and 3.05(1.67-5.58) respectively. Cannabis product choice varied by age, gender, comorbidities, prior cannabis experience, frequency of use, reasons for use, access to cannabis prescription and source of cannabis information.</p><p><strong>Conclusion: </strong>There is significant variability in cannabis products used by rheumatology patients, which are influenced by patient-specific factors. Balancing THC and CBD content may facilitate positive impact while lowering risk for side effects. Dried cannabis may pose more side effects compared to other formulations.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Physician-Scientist Pipeline for Pediatric Rheumatology - Current Landscape and Future Perspectives.","authors":"Ekemini A Ogbu, Linda T Hiraki, Mara L Becker","doi":"10.1002/acr.80073","DOIUrl":"https://doi.org/10.1002/acr.80073","url":null,"abstract":"<p><p>Over the past 50 years, the science of pediatric rheumatology has grown exponentially due to an expansion in the understanding of complex rheumatic conditions and a surge in novel targeted therapeutics. Physician-scientists in the field of pediatric rheumatology have played major roles in these advancements that have improved the care of children, adolescents and young adults with chronic and often life-threatening systemic inflammatory diseases. Despite the critical role of the physician-scientist in discovering and translating scientific advancements from the bench to bedside and vice versa that have catapulted the field of pediatric rheumatology, they remain an endangered species with a declining pipeline due to a variety of factors. In this article, we review the current landscape of the physician-scientist pipeline for pediatric rheumatology on the 50^th anniversary of the formalization of the specialty in North America. We review challenges to maintaining a thriving physician-scientist pipeline and discuss future perspectives.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance Between Patient and Physician Global Assessments in Early Systemic Sclerosis.","authors":"Ellen Romich, Alexis Ogdie, Alisa Stephens Shields, Peter A Merkel, Shervin Assassi, Elana J Bernstein, Andreea Bujor, Flavia V Castelino, Lorinda Chung, Luke B Evnin, Tracy M Frech, Jessica K Gordon, Melissa Griffith, Faye N Hant, Monica L Harding, Laura K Hummers, Dinesh Khanna, Kimberly S Lakin, Dorota J Lebiedz-Odrobina, Yiming Luo, Ashima Makol, Maureen D Mayes, Zsuzsanna H McMahan, Jerry Molitor, Duncan F Moore, Julie Paik, Carrie Richardson, Brian Skaug, Ami A Shah, Ankoor Shah, Virginia Steen, John M VanBuren, Elizabeth R Volkmann, Carleigh Zahn, Nora Sandorfi","doi":"10.1002/acr.80069","DOIUrl":"10.1002/acr.80069","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to identify factors associated with patient global assessment (PtGA) and physician global assessment (PhGA) and discordance between them in systemic sclerosis (SSc).</p><p><strong>Methods: </strong>Data from adults with early SSc (<5 years) from the Collaborative National Quality and Efficacy Registry were included. PtGA and PhGA (0-10 scale), clinical evaluations, and patient-reported outcomes (PROs) were collected every six months. Multivariable mixed-effects linear regression identified factors associated with PtGA and PhGA using (1) clinical variables and (2) clinical variables plus PROs. Relative weight analysis (RWA) determined the relative importance of each variable. Discordance (≥2 points between PtGA and PhGA) was assessed using multinomial mixed-effects logistic regression.</p><p><strong>Results: </strong>Among 956 patients (83% women, 33% limited disease), mean PtGA and PhGA at enrollment were 4.2 (SD 2.6) and 3.4 (SD 2.0), respectively (P < 0.001). RWA of clinical variables identified modified Rodnan skin score (mRSS) and New York Heart Association (NYHA) functional class as most influential for both global assessments. After including PROs, PtGA was most influenced by measures of pain, skin symptoms, and physical function. Discordance occurred in 53% of patients (35% PtGA worse, 18% PhGA worse). Worse PtGA was associated with higher overall pain and discomfort. Worse PhGA was associated with higher mRSS, worse NYHA class, higher pain interference, and lower diffusing capacity of the lung.</p><p><strong>Conclusion: </strong>Discordance between PtGA and PhGA occurs commonly, highlighting the need for comprehensive symptom management and measurement of disease burden in this complex disease. In SSc, differences in PtGA and PhGA reflect dissimilar weighting of data elements.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity subtypes and longitudinal trajectories of function over 7-years of follow-up: data from the Multicenter Osteoarthritis Study.","authors":"Kristine Godziuk, Sarah Tilley, Michael LaValley, Michael C Nevitt, Cora E Lewis, James C Torner, Tuhina Neogi","doi":"10.1002/acr.80066","DOIUrl":"10.1002/acr.80066","url":null,"abstract":"<p><strong>Background: </strong>Obesity, defined by BMI ≥30kg/m², is a risk factor for functional limitations in people with knee osteoarthritis (OA). However, function varies among such individuals. Our objective was to evaluate the implications of obesity subtypes on longitudinal patterns of physical functioning in people with or at risk for knee OA.</p><p><strong>Methods: </strong>We included participants from the Multicenter Osteoarthritis (MOST) Study with a BMI ≥30 kg/m² and DXA-measured body composition. Three obesity subtypes were defined: 1) obesity with low muscle mass (OLM) and high fat mass; 2) obesity with cardiometabolic comorbidities (OCC) but without low muscle mass; and 3) uncomplicated obesity (UO), i.e., neither OLM nor OCC. We examined the relation of these 3 obesity subtypes to self-reported WOMAC physical function at baseline, and 7-years, using linear regression at both timepoints, and to their longitudinal functional trajectory patterns using multinomial logistic regression.</p><p><strong>Results: </strong>Of the baseline sample (N=1211 individuals, 63% female, mean age 61.2±7.6 years, BMI 35.0±4.5 kg/m²), 49.1% were UO, 34.4% OLM, and 16.5% OCC. Compared to UO, the OLM and OCC groups had worse physical function at baseline. Five distinct trajectories of functioning were identified over 7-years, with 23%, 38.5%, 26%, 4.5%, and 8% of the sample in groups 1-5, respectively. Compared to UO, OLM and OCC groups had higher odds of being in the persistent poorest functioning trajectory [OR 1.9, 2.6, respectively].</p><p><strong>Conclusions: </strong>Individuals with obesity and concurrent low muscle or cardiometabolic comorbidities have persistent worse functioning over a 7-year period compared to those with obesity alone. Distinguishing obesity subtypes may enable personalized interventions to delay or avoid extended mobility disability.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}